Comparing the Effect of Continuous and Intermittent Irrigation Techniques on Complications of Arterial Catheter and Partial Thromboplastin Time in Patients Following Coronary Artery Bypass Grafting SurgerySedighehArtaMSc Student in Adults Critical Care Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorSeyed RezaMazlomEvidence based Caring Research Center, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorShahramAminiAssociate Professor of Anesthesia, Faculty of Medical, Mashhad University of Medical Sciences, Mashhad, IranauthorFatemehHajiabadiPhD Student in Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iranauthortextarticle2017engBackground: Different approaches are available to irrigate the arterial catheter, such as continuous and intermittent techniques. However, there is a disagreement regarding the most appropriate method. Aim: this study aimed to compare the effect of two continuous and intermittent irrigation methods on complications of arterial catheter and partial thromboplastin time (PTT) in patients with coronary artery bypass (CABG) surgery. Method: This randomized clinical trial was conducted on 60 participants undergoing coronary artery bypass grafting surgery in open-heart surgery ICU at Imam Reza hospital in Mashhad, Iran, in 2016. In continuous group, the arterial catheter was continuously irrigated with heparin solution at the rate of 2cc/h, and in the intermittent group with a syringe containing 5cc heparin solution every 3 hours. In both groups, catheter was monitored and recorded every 3 hours (until 48 hours and 3 times from enrollment) in terms of complications of partial thromboplastin time. Data were analyzed using SPSS version 16. Results: The findingsof independent t-test showed that the two groups are homogeneous in age (P =0.48). The result of Fisher's exact test revealed no significant difference between the two groups in terms of average incidence of complications during the first 24 hours (P=0.55) and second 24 hours (P=0.55) after catheterization. Also during the 48 hours after surgery, independent t-test results showed no statistically significant difference in partial thromboplastin time (P=0.53) between the two groups. Implications for Practice: According to the results of the research based on the lack of difference between continuous and intermittent irrigation methods up to 48 hours after catheter replacement in terms of arterial catheter complications, further long-term follow-up researches are recommended.Evidence Based CareMashhad University of Medical Sciences2008-24877

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2017714http://ebcj.mums.ac.ir/article_8332_5ffcc0ad19e16a513b37e2dd4c5cd23d.pdfdx.doi.org/10.22038/ebcj.2017.19226.1456The Impact of a Training Program Based on Learning Needs on Self-Care Behaviors among Patients with Heart FailureSeyedeh FatemehGheiasiMSc of Critical Care Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, IranauthorMahinRoohaniInstructor of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences Zanjan, IranauthorNasrinHanifiAssistant Professor of Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, IranauthorKouroshKamaliAssistant Professor of Epidemiology, School of Public Health and Medicine, Zanjan University of Medical Sciences, Zanjan, Iranauthortextarticle2017engAbstract Background: Heart failure necessitates self-care; therefore, self-care training should be based on learning needs (LNs) of patients. Aim: This study aimed to determine the impact of a training program based on learning needs on self-care behaviors among patients with heart failure Method: This clinical trial was performed on 73 patients suffering from heart failure in Zanjan teaching hospitals in 2015. The subjects were randomly divided into three groups (based on having LNs assessment and family involvement). The intervention group received education based on LNs and family involvement. Control group 1 (without LNs assessment with family involvement), and control group 2 (without LNs assessment, and family involvement). The groups received three sessions of face-to-face training (lasting 15-20 minutes) on medical symptoms, necessary measures for the disease, diet, and medication regimen. Self-care behaviors before and 90 days after the intervention were evaluated using a self-care of heart failure index. To analyze the data, analysis of variance (ANOVA) and Bonferroni post-hoc test were used in SPSS, version 11. Results: The mean age of the participants was 65.5±14.1 years. According to the results of ANOVA, the total self-care score before the intervention was not significantly different among the three study groups (P<0.05); however, this difference was statistically significant following the intervention (P<0.001). The results of the Bonferroni post-hoc test also showed a significant difference between the intervention group, control group 1 (P =0.005), and control group 2 (P<0.001). Moreover, the findings revealed a significant difference between the control group 1 and control group 2 (P<0.001). Implications for Practice: Patient education based on LNs assessment could improve self care behaviors in patients with heart failure. Further family involvement needs to be considered in the process of patient education.Evidence Based CareMashhad University of Medical Sciences2008-24877

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20171524http://ebcj.mums.ac.ir/article_8390_2d044cef5b4ede14c62d1940a35877da.pdfdx.doi.org/10.22038/ebcj.2017.21040.1487Comparison of the Effect of Face-to-Face and Multimedia Education on the Anxiety Caused by Electroconvulsive Therapy in Patients with Mood DisordersSaeedVagheeEvidence-based Care Research Center, Instructor of Nursing, Department of Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorMohsenSepehrikiaMS in Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorSeyed AliSaghebiAssistant Professor of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, IranauthorHamidrezaBehnam VoshaniEvidence-based Care Research Center, Instructor of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorAzamSalarhajiDepartment of Health, Neyshabur University of Medical Sciences, Neyshabur, IranauthorZohreNakhaee MoghaddamMS in Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iranauthortextarticle2017engBackground: Training methods to reduce the anxiety caused by the electroconvulsive therapy (ECT) should match the necessity of communicating with the patients suffering from mood disorders. Aim: This study aimed to compare the effects of face-to-face and multimedia education on the anxiety induced by the ECT. Method: This randomized controlled clinical trial was conducted on 75 patients with mood disorders undergoing ECT in the Ebn-e-Sina Psychiatric Hospital in Mashhad, Iran within 2013-2014 in three groups of face-to-face education (i.e., individual training), multimedia education (i.e., training through CD), and control (i.e., usual training), Receiving training for half an hour to get familiar with the ECT department, nursing care, and self-care one day before performing the ECT. The Spielberger's State-Trait Anxiety Inventory was completed prior to the intervention and before the first, middle, and final sessions of the ECT. The data were analyzed using the one-way and repeated measures ANOVA in the SPSS version 11.5. Results: According to the results of the study, 56% (n=14), 56% (n=14), and 48% (n=12) of the participants in the face-to-face, multimedia, and control groups were male, respectively. The post-hoc Tukey's test demonstrated that the control group had a significant difference with the face-to-face and (P=0.01) multimedia education groups (P=0.03) before the first session of the ECT. In addition, there was a significant difference between the face-to-face and multimedia education groups in this regard (P=0.07). Implications for Practice: Considering the conditions and facilities of the psychiatric hospitals, it is possible to use different methods of face-to-face or multimedia education to reduce the anxiety caused by the ECT.Evidence Based CareMashhad University of Medical Sciences2008-24877

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20172534http://ebcj.mums.ac.ir/article_8375_3ffbc49b64263b446e36ca081dacc1b9.pdfdx.doi.org/10.22038/ebcj.2017.20532.1476Comparison of the Effects of Three Different Counting Methods on Cardiopulmonary Resuscitation Quality and Rescuer FatigueJavadMalekzadehEvidence-Based Care Research Centre, Instructor of Nursing, Instructor of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorSeyed RezaMazlomEvidence-Based Care Research Centre, Instructor of Nursing, Instructor of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorAbdolghaderAssarroudiInstructor of Medical-Surgical Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, IranauthorMohammadRasouly SanganyStudent of Intensive Care Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iranauthortextarticle2017engBackground: Chest compression with adequate depth and number is one of the main indicators of high-quality cardiopulmonary resuscitation (CPR). Nevertheless, no proper counting technique is suggested to provide sufficient number of massages. Aim: To compare the effects of three techniques of chest compression counting on the quality of CPR and rescuer fatigue. Method: Inthis clinical trial, 30 rescuers (divided into three groups) performed all the three techniques of chest compression counting (without counting [common], alternate [counting from 1 to 10], and continuous [counting from 1 to 100]) in 90 different resuscitation events at Ghaem Hospital of Mashhad, Iran, in 2015. Rescuer fatigue was evaluated using visual analogue scale to evaluate fatigue, and quality of massage was evaluated by the level of end-tidal CO2 (ETCO2); massage was calculated in minutes. Data was analyzed in SPSS using ANOVA and Friedman test. Results: The mean age of the rescuers was 30.6±6.8 years. Based on Kruskal-Wallis test results, common, continuous, and alternate techniques were in descending order of fatigue level, and the common, alternate, and continuous techniques were in descending order of number of massages. In addition, according to ANOVA, the highest ETCO2 levels were observed in the alternate, continuous, and common techniques, respectively; the difference between the techniques was significant (P<0.001). Implications for practice: The use of alternate counting technique reduces rescuer fatigue, elevates ETCO2 during resuscitation, and makes approximating the number of massages to the number advised by the American Heart Association possible.Evidence Based CareMashhad University of Medical Sciences2008-24877

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20173542http://ebcj.mums.ac.ir/article_8478_2bda0949d308c95f838aaa68be5a0c0b.pdfdx.doi.org/10.22038/ebcj.2017.19821.1478The effect of Empowerment of Grandmother on Depression and Maternal Role Realization in Primiparae with Hospitalized Infant: A Randomized, Controlled, Clinical TrialSomayyehTavasolniaGraduate MSc of Nursing, Bushehr University of Medical Sciences; and Gachsaran Rajaii Hospital, Yasouj, IranauthorMaryamRavanipourAssociate Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, IranauthorFrahnazKamaliInstructor of Midwifery, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, IranauthorNiloofarMotamedAssociate Professor, Department of Community Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, IranauthorShahnazPouladiAssistant Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iranauthortextarticle2017engBackground:Hospitalization of the newborn infant can cause depression crisis and severely undermine the attainment and realization of maternal role in a primipara. The neonate’s maternal grandmother can provide the support needed to help the primipara avoid or overcome the ensuing problems. Aim: This study aimed to investigate the effect of empowerment of grandmothers on depression and maternal role realization in primiparae with hospitalized newborn. Method: In this randomized, controlled, clinical trial, 84 primiparae with their infants admitted to Shahid Rajaei Hospital of Gachsaran, Iran, were assigned to intervention and control groups. A grandmother empowerment intervention was devised by combining the concepts of Mercer’s theory with the stages of Ravanipour’s self-management empowerment model. The control group received the routine care. Depression and maternal role realization in all the primiparae were measured with Beck Depression Inventory and a researcher-made role realization questionnaire before and one month after the intervention. Data was analyzed by independent and paired t-test in SPSS, version 18. Results: The mean ages of the mothers in the intervention and control groups were respectively 27.02±5.3 and 24.0±4.1 years. Before the intervention, there was no significant difference between the depression scores (P>0.38) and role realization scores (P>0.40) of the subjects in the two groups; however, after the intervention, both scores showed significant differences (P<0.05). Implications for Practice: The intervention based on the self-management empowerment model led to significant improvement in depression and maternal role realization of the primiparae with hospitalized infant. This model can serve as a directive in neonatal wards and neonatal intensive care units.Evidence Based CareMashhad University of Medical Sciences2008-24877

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20174352http://ebcj.mums.ac.ir/article_8507_083d669395bfc14271884aaa74ab1e9b.pdfdx.doi.org/10.22038/ebcj.2017.22321.1496Comparing the Effect of Non-nutritive Sucking and Abdominal Massage on Feeding Tolerance in Preterm NewbornsSaideh MarziehFazliMSC in Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorAshrafMohamadzadehProfessor of neonatology, Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranauthorMaryamSalariThe expert responsible for the Statistics and Information Technology management, Mashhad University of Medical Sciences, Mashhad, IranauthorSoheilaKarbandiEvidence Based Care Research Centre, Instructor of Nursing, Department of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iranauthortextarticle2017engBackground:Enteral feeding intolerance is a major problem in the preterm neonates. Non-nutritive sucking and abdominal massage are among the most important nutritional interventions in this regard. Aim: This study aimed to compare the effect of non-nutritive sucking and abdominal massage on feeding tolerance in the preterm newborns. Method: This clinical trial was conducted on 52 preterm neonates in the Neonatal Intensive Care Unit of Imam Reza Hospital in Mashhad, Iran. The subjects were randomly divided into three groups, namely abdominal massage (17 newborns), non-nutritive sucking (18 newborns), and control groups (17 newborns). In the abdominal massage group, the intervention was fulfilled for 15 min twice a day, and in the non-nutritive sucking group, the intervention was performed for 10 min three times a day within 7 days. The control group only received tube feeding every two h without any intervention. Feeding tolerance was examined in terms of gastric residuals, vomiting, and abdominal distention. The data were collected through the recording daily information form. The data were analyzed through SPSS version 23, using ANOVA test and marginal models. Results: The mean gestational age of the abdominal massage group was 32.8±1.0 weeks. This value was 32.5±1.3 weeks in both sucking and control groups. Generalized estimating equation revealed that non-nutritive sucking was effective in the absence of distention (P=0.01) and vomiting (P=0.01). However, abdominal massage was effective only in the absence of vomiting (P=0.01). Implications for Practice: The use of non-nutritive sucking can increase the feeding tolerance in the preterm newborns. Evidence Based CareMashhad University of Medical Sciences2008-24877

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20175359http://ebcj.mums.ac.ir/article_8506_ae1f91de50a5092145e833d199d22a16.pdfdx.doi.org/10.22038/ebcj.2017.20679.1479The Effect of Implementing a Discharge Program on Quality of Life of Mothers with Premature InfantsAzamNeyestaniMSc in Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorRezaSaeidiAssistant Professor of Neonatology, Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranauthorMaryamSalariThe Expert Responsible for the Statistics and Information Technology Management, Mashhad University of Medical Sciences, Mashhad, IranauthorSoheilaKarbandiEvidence Based Care Research Centre, Instructor of Nursing, Department of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iranauthortextarticle2017engBackground:Quality of life is low among mothers of premature infants; therefore, developing a post-discharge care program can be effective. Aim: This study aimed to investigate the effect of implementing a discharge program on the quality of life of mothers with premature infants. Method: This randomized, controlled, clinical trial was conducted on 60 mothers with premature infants in the neonatal intensive care unit (NICU) of BentolHoda Hospital, Bojnord, Iran, during 2015-2016. The participants were divided into two groups of intervention (four training sessions on caring for premature infant, screening, and four-week telephone counseling post-discharge) and control (routin care in NICU). Maternal quality of life was evaluated using the short form of the World Health Organization Quality of Life Questionnaire at the onset of the study, at discharge, and four weeks after discharge. The data was analyzed in SPSS, version 16, using repeated measures analysis of variance (ANOVA). Results: The mean ages of the intervention and control groups were 26.8±5.1 and 29.5±5.3 years, respectively. According to the findings of independent t-test, the total mean score for maternal quality of life before the intervention showed no significant differences between the intervention and control groups (P=0.48). However, the results of repeated measures ANOVA revealed statistically significant differences between the scores of quality of life at three-time measurements within both study groups (P<0.001). Implications for Practice: The designed premature infant discharge program can improve quality of life of mothers. Thus, we suggest it as an effective method for promoting quality of life among mothers of preterm infants. Evidence Based CareMashhad University of Medical Sciences2008-24877

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20176071http://ebcj.mums.ac.ir/article_8479_95cecd5df600c46b8f06b4bb212075e5.pdfdx.doi.org/10.22038/ebcj.2017.21095.1482Investigating the Relationship between Anxiety of School-age Children Undergoing Surgery and Parental State-trait AnxietyFatemehHeshmati NabaviAssistant Professor of Management Nursing, Evidence Based Care Research Centre, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorMaliheShojaMSc in Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorMonirRamezaniAssistant Professor of Pediatric Nursing, Evidence Based Care Research Centre, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranauthorAzadehSakiAssistant Professor, Department of Environmental Statistics and Epidemiology, Mashhad University of Medical Sciences, Mashhad, IranauthorMarjanJoodiAssistant Professor of Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iranauthortextarticle2017engBackground: Surgery is a stressful experience for children, and preoperative anxiety in children could be affected by the level of parental anxiety. Aim: The aim of this study was to determine the relationship between anxiety in school-age children before surgery and parental state-trait anxiety. Method: This descriptive study was performed on 81 children within the age group of 6-12 years admitted for elective surgical operation and 128 parents in Doctor Sheikh Hospital, Mashhad, Iran, 2016. Children's anxiety and parental anxiety were measured before the entrance of the patients to the operating room via Revised Children's Manifest Anxiety Scale (RCMAS) and Spielberger’s State-Trait Anxiety Inventory, respectively. The data was analyzed in SPSS, version 16, using the relevant statistical tests. Results: The results of Pearson product-moment correlation test showed a positive correlation between children's anxiety and fathers' state anxiety and between children's anxiety and mothers' state anxiety (r=0.27, r=0.41; P=0.005, P=0.040, respectively). However, no statistically significant relationship was observed between children's anxiety and parents' trait anxiety, age of children, as well as parents' educational level, occupation, and level of trait anxiety. Implications for Practice: Considering the association between parents' state anxiety and children's anxiety, implementing preoperative interventions to prepare parents for surgery is recommended. Evidence Based CareMashhad University of Medical Sciences2008-24877